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. 2019 Apr:44:113-119.
doi: 10.1016/j.breast.2019.01.008. Epub 2019 Feb 2.

Characteristics and prognosis of stage I-III breast cancer subtypes in Brazil: The AMAZONA retrospective cohort study

Sergio Daniel Simon  1 , José Bines  2 , Gustavo Werutsky  3 , João Soares Nunes  4 , Fernando Chalu Pacheco  5 , José Getúlio Segalla  6 , Andrea J S Gomes  7 , Brigitte Marie H R Adam Van Eyll  8 , Daniel Luiz Gimenes  9 , Susanne Crocamo  10 , Ruffo Freitas-Junior  11 , Lissandra Dal Lago  12 , Geraldo Silva Queiroz  13 , Sérgio Jobim de Azevedo  14 , Daniela Dornelles Rosa  15 , Gilson Delgado  16 , Giuliano Santos Borges  17 , Yeni Verônica do Nascimento  18 , Facundo Zaffaroni  3 , Jeovany Martínez-Mesa  19 , Carlos H E Barrios  3
Affiliations

Characteristics and prognosis of stage I-III breast cancer subtypes in Brazil: The AMAZONA retrospective cohort study

Sergio Daniel Simon et al. Breast. 2019 Apr.

Abstract

Objective: To describe stage I-III breast cancer (BC) molecular subtypes and outcomes among a cohort of patients from Brazil.

Methods: AMAZONA study is a retrospective cohort conducted from June 2008 to January 2009 including women of at least 18 years old, with histologically proven breast cancer, diagnosed in 2001 (n = 2198) and 2006 (n = 2714). In this analysis, we included patients who underwent surgery, had stage I-III disease and available pathological information (n = 2296). We estimated molecular subtypes by local immunohistochemical stains. Data was obtained from medical charts and public databases.

Results: Mean age at diagnosis was 54 years and 41.1% were younger than 50 years. 23.3% were diagnosed in stage I, 53.5% in stage II and 23.2% in stage III. 80.8% were treated in the public health system. 71.3% had hormonal receptor positive disease, 15.7% were HER-2 positive and 21.1% had triple-negative breast cancer. 55.6% were treated with mastectomy and 96.2% received adjuvant treatment (82.2% chemotherapy). 13.4% of HER-2 positive patients received adjuvant trastuzumab. Overall survival rate at 5 years was 96.84% for stage I, 94.16% for stage II and 70.48% for stage III. Molecular subtypes were independent prognostic factor in stages II and III patients.

Conclusions: Brazilian women have a higher risk of being diagnosed with late stage breast cancer and younger age than in high-income countries. Luminal-like disease is the most common molecular subtype in the country. Triple negative and HER-2 positive had the worst prognosis.

Keywords: Brazil; Breast neoplasms; Epidemiology; Molecular typing.

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